| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,336 |
1,976 |
$106K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
997 |
953 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
219 |
213 |
$12K |
| 92551 |
|
615 |
613 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
38 |
38 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$2K |
| 99173 |
|
624 |
623 |
$2K |
| 90686 |
|
145 |
140 |
$1K |
| 90656 |
|
34 |
34 |
$287.52 |
| 90688 |
|
15 |
15 |
$239.60 |
| 99072 |
|
29 |
28 |
$0.00 |